Bill Gates’s pandemic plan: so ambitious it is meaningless
Bill Gates is, as he coyly admits early in this prescription for beating pandemics, the subject of “crazy conspiracy theories”. During Covid, the most widespread accused him of dishing out vaccines laced with microscopic chips to track and control humanity. The attacks were “intense”, he notes, and left him with a problem. “I have never known whether to engage with them or not. If I ignore them, they keep spreading. But does it actually persuade anyone who buys into these ideas if I go out and say, ‘I am not interested in tracking your movements – I honestly don’t care where you’re going’?”
Perhaps this book is his solution. For, rather like that other super-rationalist Emmanuel Macron doing his best to contain his despair (and disdain?) during France’s presidential campaign debates with Marine Le Pen, Gates has done his best to temper his frustration with the low-functioning nonbillionaire community (that’s you and me) and composed a patient recitation of facts and stats about Covid and global healthcare in general.
Apart from when he lets rip about the “terrible advice” of Donald Trump and his administration (“I remember one especially heated call… in which I was quite rude”), Gates is desperately careful not to sound patronising. He tries really hard to keep things uncontroversial, to come off as anything but a cajoling elitist imposing
Gates tries to come off as anything but an elitist imposing his will on the people
his lizard-headed will on the people of the planet. He wants these pages to be sensible and dull, like his dress sense. And the problem is, he succeeds.
Which is probably how it should be. After all, Gates is the man who, through his foundation, spotted that there was lots of low-hanging fruit to be plucked when it came to improving global health, precisely by doing the unglamorous, lo-tech side of things like ensuring that babies in Africa did not die in quite such huge numbers through diarrhoea-induced dehydration and nutrition loss. We may know him as the man who gave us PC software but – like so many tech company bosses – it is not tech per se but rather the engineering of efficient solutions that really floats his boat.
Perhaps that is why he thinks he can solve, or at least improve, so much. His last book was about climate change, that other issue which, along with pandemics, he considers “existential” for mankind. So far, so Greta Thunberg or Extinction Rebellion, you might think – but Gates’s contrarian book was optimistic, down to the title: How to Avoid a Climate Disaster. Now, with the same can-do, roll-up-the-sleeves attitude, he lays out, step by step, the system that needs to be put in place to prevent another – potentially far more deadly – pandemic.
Gates makes all the usual claims about any sensible prevention wishlist: by spending a little bit extra now (he suggests $55billion – £44billion – a year globally) on lots of things, we will make ourselves far safer and prosperous in the future. The problem is that while some of his specific prescriptions make obvious sense (improved global disease surveillance) or are at least realistic (a dedicated pandemic response team 2,000 to 3,000 strong), others seem so ambitious as to feel almost meaningless.
Sure, who doesn’t want better tools for preventing, detecting and treating infectious disease with improved vaccines, diagnostics and treatments? At least Gates uses his long experience of medical development paths to explain how, in the best case, such improved drugs might be delivered. He also knows better than most the extraordinary challenges that come with, say, trying to build vaccine factories in low-income regions, and ensure they are safe.
But when he announces that one key task is “strengthening healthcare systems in low- and middle-income countries”, this reader’s response was: “You don’t say.”
Which is frustrating because, as he rightly points out, the prize is potentially enormous: the “eradication [of ] whole families of respiratory disease, which would mean no more coronaviruses like Covid – and even better, no more flu”.
More interesting than his warnings about future hypotheticals, then, is his analysis of the actual past, where he can set his systems-brain to draw up costs and benefits. So he is hugely pro-mask (even while admitting to not having worn one in a meeting while feeling ill in March 2020).
He also engages with the thorny issue of school closures, the argument for which was “muddied by some initial data that turned out to be misleading”. It actually turned out that the “rates of infection and illness in children were comparable to the rates in adults”. They didn’t get as sick, of course, but they could pass on the illness. Even so, he reckons next time, provided the disease behaves like Covid, “long-term school closures should not be necessary”.
This, though, is as close, really, as he gets to addressing the broader cultural impact of Covid. His accountant’s eye weighs up with unflinching rationality what is good for people, but struggles more with what they might feel to be important. There are the things even he concedes are “literally uncountable costs” – the mental health impacts, the educational inequities, barring families from dying relatives.
As a result, it is a strangely bloodless book about blood and tears on a vast scale. Such capacity for cool calculation has of course made Gates’s fortune. And, through his foundation, saves countless lives. But in focusing relentlessly on the big picture, he seems oddly detached from the experience of individuals. If one death is a tragedy, and a million deaths a statistic, Gates is inevitably, and rightly, drawn to the statistics. But is it any wonder those who experience tragedy don’t always feel drawn to him?